Lingnan Modern Clinics in Surgery ›› 2014, Vol. 14 ›› Issue (04): 375-378.DOI: 10.3969/j.issn.1009-976X.2014.04.007
• 论文 • Previous Articles Next Articles
马琳1,张祥茂2, 黄楹
通讯作者:
Abstract: 【Abstract】〓Objective〓To investigate the feasibility of bypass between the maxillary artery.(MA) and proximity of the second segment of middle cerebral artery (MCA). Methods〓The superficial temporal artery and its branches,.MA and deep temporal artery,.the bifurcation of MCA,.the bifurcation of common carotid artery,.the beginning of external and internal carotid artery were dissected in ten perfused adult cadaver heads(20 sides),.and the outer diameters were measured respectively..The lengths of grafts vessels between the external carotid artery,.internal carotid artery,.MA and proximal MCA were measured respectively..Ten healthy adults(20 sides) were also included in the study..The inner diameter and blood flow dynamic parameters of the MA,.common carotid artery,.external carotid artery,internal carotid artery,.superficial temporal artery and its two branches were measured with ultrasound examination. Results〓The outer diameter of MA was (2.60±0.20) mm,.which was larger than that of the temporal artery trunk(1.70±0.30) mm. The lengths of grafts vessels between the external carotid artery,.internal carotid artery and MCA bifurcate department were (162.40±2.60) mm and (171.00±2.70) mm,.respectively,.which were longer than that between MA and MCA bifurcate department (61.70±1.50) mm. The blood flow of the second segment of MA was (62.70±13.30) ml/min,.which was more than that of the two branches of the superficial temporal artery (15.90±3.70) and (17.70±4.10) ml/min,.respectively. Conclusion〓Bypass between the maxillary artery and proximity of the second segment of middle cerebral artery is feasible..It is a kind of effective high flow bypass,.with which the graft vessel is shorter and straighter.
Key words: Maxillary artery, Middle cerebral artery, Bypass, Blood flow, Anatomy
摘要: 【摘要】〓目的〓探讨上颌动脉与大脑中动脉第二段近端之间进行血管搭桥的可行性。方法 解剖观察10具尸头标本(20侧)的颞浅动脉、上颌动脉及颞深动脉、大脑中动脉分叉部、颈总动脉分叉部及颈外、颈内动脉起始部,分别测量其外径,颈外、颈内动脉起始部及上颌动脉至大脑中动脉分叉部移植血管的走行距离。多普勒超声检查10例健康成人(20侧)的上颌动脉、颈总、颈外、颈内动脉及颞浅动脉主干、额支、顶支的内径和相关血流动力学参数。 结果〓尸头解剖上颌动脉外径为(2.60±0.20) mm,大于颞浅动脉分叉部外径(1.70±0.30) mm,两者差异具有统计学意义(P<0.05);上颌动脉至大脑中动脉分叉部移植血管的行程为(61.70±1.50) mm,而颈外、颈内动脉至大脑中动脉分叉部移植血管的行程分别为(162.40±2.60) mm、(171.00±2.70) mm。超声多普勒检查上颌动脉第二段血流量为(62.70±13.30) mL/min,而颞浅动脉额支、顶支血流量仅(15.90±3.70) mL/min、(17.70±4.10) mL/min,均具有统计学差异(P<0.05)。结论〓上颌动脉与大脑中动脉第二段近端进行血管搭桥是切实可行的,具有血流量大、移植血管短、路径直等优点,是一种有效的颅内外血管搭桥方法。
关键词: 上颌动脉, 大脑中动脉, 搭桥术, 血流量, 解剖学
CLC Number:
R651.1
R323
马琳 张祥茂 黄楹. 上颌动脉-大脑中动脉血管搭桥的解剖学研究[J]. 岭南现代临床外科, 2014, 14(04): 375-378.
0 / / Recommend
Add to citation manager EndNote|Ris|BibTeX
URL: http://www.lingnanwaike.com/EN/10.3969/j.issn.1009-976X.2014.04.007
http://www.lingnanwaike.com/EN/Y2014/V14/I04/375
参考文献: [1] Sekhar LN,Natarajan SK,Ellenbogen RG,et al. Cerebral revascularization for ischemia,aneurysms,and cranial base tumors. Neurosurgery,2008,62(6 Suppl 3):1373-1410. [2] Ramanathan D,Temkin N,Kim LJ,et al. Cerebral bypasses for complex aneurysms and tumors:long-term results and graft management strategies. Neurosurgery,2012,70(6):1442-1457. [3] Sekhar LN,Kalavakonda C. Cerebral revascularization for aneurysms and tumors[J]. Neurosurgery,2002,50(2):321-331. [4] Ustun ME,Buyukmumcu M,Ulku CH,et al. Radial artery graft for bypass of the maxillary to proximal middle cerebral artery:an anatomic and technical study[J]. Neurosurgery,2004,54(3):667-671. [5] Ulku CH,Ustun ME,Buyukmumcu M,et al. Radial artery graft for bypass of the maxillary to proximal posterior cerebral artery:an anatomical and technical study[J]. Acta Otolaryngol,2004,124(7):858-862. [6] 莫大鹏,凌锋,李萌,等.颌内动脉-大脑中动脉移植吻合解剖学研究[J].中华神经外科疾病研究杂志,2005,4(1):51-54. [7] 徐善才,史怀璋,刘增尧,等.上颌动脉与颈内动脉搭桥解剖学研究[J].中华神经外科杂志,2009,25(8):704-707. [8] Shi X,Qian H,K C KI,et al. Bypass of the maxillary to proximal middle cerebral artery or proximal posterior cerebral artery with radial artery graft. Acta Neurochir(Wien),2011,153(8):1649-1655. [9] 周忠清,石祥恩,张永力,等.桡动脉移植颌内动脉-大脑中动脉搭桥术一例并文献复习[J].中华神经外科杂志,2010,26(6):541-543. [10] 高树梓,石祥恩,张永力,等.颌内动脉-大脑中动脉搭桥治疗缺血性脑血管病的临床研究[J].中华神经外科杂志,2012,28(11):1109-1112. [11] 石祥恩,张永力,刘方军,等.颌内动脉搭桥治疗颅内巨大动脉瘤[J].中华神经外科杂志,2013,29(1):37-40. [12] Sekhar LN,Sen CN,Jho HD. Saphenous vein graft bypass of the cavernous internal carotid artery[J]. J Neurosurg,1990,72(1):35-41. [13] Sekhar LN,Burgess J,Akin O. Anatomical study of the cavernous sinus emphasizing operative approaches and related vascular and neural reconstruction[J]. Neurosurgery,1987,21(6):806-816. [14] Spetzler RF,Fukushima T,Martin N,et al. Petrous carotid-to-intradural carotid saphenous vein graft for intracavernous giant aneurysm,tumor,and occlusive cerebrovascular disease[J]. J neurosurg,1990,73(4):496-501. [15] Ausman JI,Nicologg DM,Chou SN. Posterior fossa revascularization: anastomosis of vertebral artery to PICA with interposed radial artery graft[J]. Surg Neurol,1978,9(5):281-286. [16] Hanel RA,Spetzler RF. Surgical treatment of complex intracranial aneurysms[J]. Neurosurgery,2008,62 (6 Suppl 3):1289-1299. [17] Mura J,Malogo-Tavares W,Figueiredo EG. Basic aspects of high flow extracranial-intracranial bypass:part I[J]. Contemp Neurosurg,2010,32(4):1-4. [18] Umansky F,Juarez SM,Dujovny M,et al. Microsurgical anatomy of the proximal segments of the middle cerebral artery[J]. J Neurosurg,1984,61(3):458-467. [19] Vrionis FD,Cano WG,Heilman CB. Microsurgical anatomy of the infratemporal fossa as viewed laterally and superiorly[J]. Neurosurgery,1996,39(4):777-786.